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Tuesday, January 25, 2011

Work Out Smarter, Not Harder: How to Prevent Injury in a New Workout Regime

It’s the first month of the New Year, and like so many Januarys past, gyms are bustling with an eager clientele full of resolutions to lose weight and stay in shape.  While the motivation and determination is admirable, those returning to (or embarking on) an active lifestyle must resist the temptation to rush into things.  According to a study conducted by the American Journal of Sports Medicine from 1990 to 2007, 25,335 weight training injuries were seen in the 100 US emergency departments they monitored, correlating to an estimated 970,801 injuries nationwide. As high as these numbers are, this doesn’t mean that weight training itself is innately unsafe; there are ways to prevent injury.
In order to have a better understanding of muscle injury, let’s explore the mechanisms of muscle contraction. There are three different classifications of muscles: striated voluntary skeletal, striated involuntary cardiac, and non-striated involuntary smooth muscle. When you exercise you are primarily utilizing the skeletal & cardiac muscles.
Skeletal muscle’s primary functions are the voluntary contractions that give us locomotion and skeletal movement. For example when we stand up, we cognitively tell our bodies to move, and the skeletal muscles react to carry out the appropriate motion. Cardiac muscle, on the other hand, is involuntary and regulated by the autonomic nervous system. Think of it this way: you don’t have to tell your heart to beat; your body does that on its own. When we exercise it is important to understand that these are the two muscle groups that are working synergistically to help feel the burn!
Muscle injuries occur when an individual who is not conditioned jumps into a regime which is too strenuous, resulting in torn muscle fibers, ligaments, or even injuring the bone surfaces underneath. The most common issues that occur are sprain/strain injuries; these occur when a ligament or a muscle is pushed past its physiological barrier and is stretched to tissue damage. Tendinitis, another common injury, occurs with overuse of the muscle.
The body is a complicated, but smart, system. You may have heard the term “muscle memory;” your muscles are aware of work that is familiar and work that is unfamiliar. This is the key to injury prevention. If you’re jumping head first into a new routine of physical activity, you must give your muscles a chance to catch up to you.
What does this mean for your workout specifically? You’ve probably heard it over and over, but it is absolutely vital to warm up before exercise. Think of your muscles as rubber bands; when you put a rubber band in the freezer and try to stretch it it will snap. When the rubber band is nice and warm it will stretch to its physical limits. Warming up before your workout should only take 5-10 min. To make sure that your body is properly warmed up, you should achieve slight perspiration. Incorporate stretching and mild exercise to slowly bring your heart rate up.This small step will increase the effectiveness of your workout tenfold.
The next step is your workout. Truth is, most people aren’t educated on exercise science, and when they enter a gym they’re overwhelmed and dive into what they know. They’ll do an hour on a treadmill, a couple reps on a machine that looks familiar, and add too much weight too quickly to feel like they’ve challenged themselves. This will work for about a week or two before you encounter injury, or the all too familiar workout rut. The best route to take is a full body workout that focuses on the core muscle groups and stabilizing muscles. Do a little research to find a plan that works best for you. Try incorporating practices like yoga or Pilates into your routine to challenge your muscles in different ways. One really good source of information is the website for a local business here in Newton called Gymnasium (http://www.inspiredperspiration.com/). One particular blog post (written by the owner, Josh Conway) references the importance of working out not only the “mirror muscles” (pectorals, biceps, and abs), but also the connecting, deeper, stabilizing muscles. These are the ones that we use most often in real life activity yet focus on the least when working out, which is what leads to common strains and sprains. Remember: getting into a healthy lifestyle is a marathon, not a sprint. Listen to your body, and start out slow. As you feel your body growing accustomed, up the intensity. In general, your body loves to be challenged. A typical work out regime will most often lead you to hit a physical and physiological plateau. By constantly changing the intensity and amplitude of your workout, you’ll be able to not only avoid the gym doldrums, but also see and feel changes in your body quicker.
And don’t forget: after the workout is done…cool down! Stretching is (once again) vital. During the workout, muscle fibers are being torn. Stretching will help them regenerate properly (and more quickly!) and prevent chronic scar tissue formation. Scar tissue forms when fibroblasts (collagen-forming stem cells) invade an area of injury and deposit collagen to try to patch the damaged tissue. This is what causes chronic injuries to joints like ankles, shoulders, and knees. Take the 10 minutes after your workout to ensure all the work you did wasn’t in vain.
Two muscle groups to focus on are the psoas and the hamstrings. These are big postural muscles that are often tight. Try to use stretches that incorporate the whole body and slow down your heart rate; yoga poses are a great way to do this. 
Keep in mind that the point of a workout regime is to improve yourself, not make things worse. Take your time! If you stick to a full body, varied regime that increases in intensity slowly over time, I promise you’ll see results you’re happy with and feel the positive changes in your body.

Wednesday, January 5, 2011

working on a blog about the importance of pacing yourself on your new year’s resolution work out regime. work out smarter, not harder!

Tuesday, January 4, 2011

Legitimizing a Discipline: Evidence-Based Chiropractic

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The field of chiropractic is a difficult one for an outsider to understand. For starters, it covers a wide range of practices. Think of the last time you saw a chiropractor’s office: it was most likely located right near another. This is because each practice has the potential to be markedly different. A brief history of the profession shows that it was originally based mainly in philosophy and therefore categorized as complementary and alternative medicine (CAM). Many doctors today still adhere to this ideology; they are known as traditional or straight chiropractors. They deal almost exclusively with the manipulation of the spine & believe subluxations to be the root of all problems in the body.
However, in recent years, as a reaction to the generally negative opinion the field of medicine had towards chiropractic, some doctors have started to move into an era of evidence-based care. So what does this mean exactly? In a nutshell, evidence-based chiropractic involves the use and implementation of researched, proven techniques for treating specific conditions. This, combined with a doctor’s clinical experience, is used to create a very specific and efficient treatment regime for each patient. It incorporates physical therapy, soft-tissue mobilization, ultrasound, and other musculoskeletal therapies. These chiropractors, like me, look at the body as a whole, interconnected system and treat it as such.
Before becoming a chiropractor I had a strong background in science. I worked in biotechnology for three years developing compounds for pharmaceutical use as well as harvesting stem cells for treatment of Myocardial Infarction. While in these fields I learned to find, read and analyze research. This is where I found my passion for evidence-based medicine, and why I chose to open my own practice.
My practice in West Newton is currently filled with pieces of equipment (or as my staff and I call them, “toys”). As a gadget lover, I research and find new and interesting things that will increase patient outcomes. The advantage of working in an evidence based practice is that there is a vast database of treatment protocols to pull from. Every patient is different; some people will react well to a treatment regime of Graston, rehab, and manipulation, but their friend with the same symptoms may require something different, like vibration therapy. To me, this is the fun part of being in practice; I’m a detective using peer-reviewed articles and case studies as my tool box to try to determine and treat the problem.
If you walk into my clinic, you will notice that I utilize a variety of techniques. I live in a world of muscle, bone, and fascia. Most of the treatment protocols revolve around addressing those components. Graston Technique for the fascia, rehab for the muscle, and chiropractic manipulation for the bone. It is my responsibility to take what I know to find ways to improve and balance the three.
Before judging the field of chiropractic, be sure to take the time to research it. Most people are unaware of the variations in treatment types from one doctor to the next, and could in turn be missing out on the ideal solution to their chronic injuries and pain.
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